H. Ottershttp://repub.eur.nl/ppl/10615/
List of Publicationsenhttp://repub.eur.nl/eur_signature.pnghttp://repub.eur.nl/
RePub, Erasmus University RepositoryModerately overweight and obese patients in general practice: A population based surveyhttp://repub.eur.nl/pub/60911/
Fri, 07 Jul 2006 00:00:01 GMT<div>L. van Dijk</div><div>H. Otters</div><div>A.J. Schuit</div>
Background: Obesity is a main threat to public health in the Western world and is associated with diseases such as diabetes mellitus and coronary heart diseases. Up to now a minority of research studied the relation between obesity and the use of primary health care. In the Netherlands the general practitioner (GP) is the main primary health care provider. The objective of this article is to evaluate GP consultation and prescription of drugs in moderate and severely overweight (obese) persons in the Netherlands. Methods: Data were used from a representative survey of morbidity in Dutch general practice in 2001. Our study sample consisted of 8,944 adult respondents (18+ years) who participated in an extensive health interview. Interview data were linked to morbidity and prescription registration data from 95 general practices where respondents were listed. Body mass index (BMI) was calculated using self-reported height and weight. Analyses were controlled for clustering within practices as well as for socio-demographic and life style characteristics. Results: Obesity (BMI ≥ 30 kg/m2) was observed in 8.9% of men and 12.4% of women; for moderate overweight (BMI 25-<30 kg/m2) these percentages were 42.2% and 30.4% respectively. Obese men and women were more likely to consult their GP than persons without overweight. This especially holds for diseases of the endocrine system, the cardiovascular system, the musculoskeletal system, the gastro-intestinal system, and skin problems. Related to this, obese men and women were more likely to receive drugs for the cardiovascular system, the musculoskeletal system, alimentary tract and metabolism (including, for example, antidiabetics), and dermatologicals, but also antibiotics and drugs for the respiratory system. For moderately overweight men and women (BMI 25-<30 kg/m2) smaller but significant differences were found for diseases of the endocrine system, the cardiovascular system, and the musculoskeletal system. Conclusion: Obesity increases the workload of Dutch general practitioners and the use of prescribed medication. The current increase in the prevalence of obesity will further increase the use of health care and related costs. Since a large majority of Dutch persons visit their GP over the course of one year, GPs' potential role in effective prevention strategies cannot be denied.Epidemiology of unintentional injuries in childhood: a population-based survey in general practicehttp://repub.eur.nl/pub/10393/
Sat, 01 Jan 2005 00:00:01 GMT<div>H. Otters</div><div>F.G. Schellevis</div><div>J. Damen</div><div>J.C. van der Wouden</div><div>L.W.A. van Suijlekom-Smit</div><div>B.W. Koes</div>
This study aimed to assess the incidence of unintentional injuries
presented in general practice, and to identify children at risk from
experiencing an unintentional injury. We used the data of all
0-17-year-old children from a representative survey in 96 Dutch general
practices in 2001. We computed incidence rates and multilevel multivariate
regression analysis in different age strata and identified patient and
family characteristics associated with an elevated injury risk. Nine
thousand four hundred and eighty-four new injury episodes were identified
from 105 353 new health problems presented in general practice, giving an
overall incidence rate of 115 per 1000 person years (95% confidence
interval [CI] = 113 to 118). Sex and residence in rural areas are strong
predictors of injury in all age strata. Also, in children aged 0-4 years,
a higher number of siblings is associated with elevated injury risk (> or
=3 siblings odds ratio [OR] = 1.57, 95% CI = 1.19 to 2.08) and in the
12-17-year-olds, ethnic background and socioeconomic class are associated
with experiencing an injury (non-western children OR = 0.67, 95% CI = 0.54
to 0.81; low socioeconomic class OR = 1.39, 95% CI = 1.22 to 1.58).
Unintentional injury is a significant health problem in children in
general practice, accounting for 9% of all new health problems in
children. In all age groups, boys in rural areas are especially at risk to
experience an injury.Trends in prescribing antibiotics for children in Dutch general practicehttp://repub.eur.nl/pub/61827/
Sun, 01 Feb 2004 00:00:01 GMT<div>H. Otters</div><div>J.C. van der Wouden</div><div>F.G. Schellevis</div><div>L.W.A. van Suijlekom-Smit</div><div>B.W. Koes</div>
Dutch general practitioners' referral of children to specialists: a comparison between 1987 and 2001http://repub.eur.nl/pub/10367/
Thu, 01 Jan 2004 00:00:01 GMT<div>H. Otters</div><div>J.C. van der Wouden</div><div>F.G. Schellevis</div><div>L.W.A. van Suijlekom-Smit</div><div>B.W. Koes</div>
BACKGROUND: Although children are frequently referred to specialists,
detailed information on referral patterns of them is scarce. Even less
information is available on how referral patterns evolve over time. AIMS:
To examine current referral patterns for children aged 0-17 years and
compare these with referral patterns reported for 1987.Design of study:
Data were analysed from two national cross-sectional surveys, performed in
2001 (91 general practices) and in 1987 (103 general practices).SETTING:
Dutch general practice.METHOD: All new referrals to specialists were
assessed by age, sex, International Classification of Primary Care (ICPC)
category, specialty referred to, and specific episodes of disease.
Referral measures were quantified as new referrals per 1000 person-years
and per 100 new episodes, a measure of likelihood of a young person with a
specific diagnosis to be referred. Rates in 2001 were compared with those
from 1987. RESULTS: Referral rates decreased from 138 per 1000
person-years in 1987, to 84 per 1000 person-years in 2001. Age differences
in referral rates were similar in both surveys. Compared with 1987, more
boys than girls were referred to specialists. The overall likelihood of a
condition being referred decreased from 8.0 per 100 episodes in 1987 to
6.5 per 100 episodes in 2001. Reasons for referral had also changed by
2001, particularly for the ear, nose, and throat (ENT) specialist and
ophthalmologist. Moreover, referral rates for acute otitis media,
refractive disorders, and vision problems decreased two- to fourfold in
2001. CONCLUSION: Presently, Dutch general practitioners tend to manage
more health problems themselves and refer less young people to
specialists.Exercise and Weight Loss in Obese Postmenopausal Women [2] (multiple letters)http://repub.eur.nl/pub/52148/
Wed, 09 Apr 2003 00:00:01 GMT<div>H. Otters</div><div>P.D.D.M. Roelofs</div><div>A.P. Verhagen</div><div>M.L. Irwin</div><div>A. McTiernan</div><div>J. Potter</div>